15,000 people in Pakistan facing renal failure every year

With an estimated 15,000 people in Pakistan are facing renal failure every year, there is dire need to regulate kidney transplantation in the country through a comprehensive law instead of imposing a complete ban over kidney transplant.
Colonel Dr Mukhtar Hamid Shah (Retd), member International Society of Nephrology stated this while addressing a media workshop organised by the Pakistan Kidney Patients Association.
Dr Shah, who is world kidney transplant holder, stated that kidney transplant was the only affordable patients for saving the lives of patients facing renal failure. Kidney transplant cost around Rs 200,000 while dialysis required Rs 600,000 per annum for the rest of life of the patient.
Dr Mukhtar Hamid Shah, who claims to have conducted 3000 kidney transplant operations since 1986, asked the government to look into the miseries of patients facing renal failure before making any legislation. He suggested that the unrelated donation and payments be regulated to save lives of the needy patients instead of being banned altogether.
He also proposed setting up of Donor's Payment Trusts and Donors Welfare Trusts. Only the authorised hospitals be allowed kidney transplantation where special committees be formed to monitor the process.
He also suggested that the committee should maintain the record; the donor should be accompanied with one of his close first degree relation; the donor should submit his consent witnessed by two persons, one of which should be his close relation; the government should fix the compensation, which should be paid out of the Donors' Welfare Fund and this amount should cover his expenses incurred for his treatment, travel, meals and being absent out of his job etc, and reward/compensation money, which should be equivalent to the 'arsh'; the donor should be insured medically for his ailment for his future life.
Dr Shah, who is President of Society of Transplant Physicians and Surgeons, has expressed reservations on the bill, being introduced by the government in the Senate shortly, concerning donation and transplantation of human organs. He claimed that the proposed bill discourages the donations by unrelated (other than relatives) donors for monetary compensations.
The federal government must provide alternative facilities for kidney transplantation, which may cost billions, to the ever-increasing patients every year. As the government plans to present a "Cadaveric Bill" (transplantation of kidneys of the deceased persons) it is unlikely to cater to the load of dying and destitute patients in Pakistan, whereas a huge amount will have to be incurred for creating necessary infrastructure (establishing 525 CCUs's, appointment of specialists, telecommunication system, transport to carry the organs, tissue typing laboratories) across the country. India introduced Human Organ Act in 1994.The implications of this Bill in India must be studied to learn more lessons, he argued.
Until, the government allocated more financial resources to healthcare and critical care units, develops infrastructure, telecommunication systems and transportation facilities, the cadaver programme would never take off, he opined.
He stated that under the proposed bill, the sale, purchase, export, or any attempt or abetment for sale or purchase of any human body shall be punishable with imprisonment, which may extend to seven years but shall not be less than three years and with fine.
Where an employee of a hospital, clinic, mortuary or graveyard or any other person connected in any manner with a hospital, clinic, mortuary or graveyard indulges in sale, purchase, export of human bodies or any organ thereof shall be punishable with imprisonment, which may extend to seven years and with fine, he said.
'It is strange that 'qisas' allowed payment of 'arsh" for the criminal infliction of injuries against the will of a person, damaging his organ, and the culprit was excused only on the payment of 'arsh'. What is extra in kidney transplantation, he questioned. Government of Iran, he said is paying US $2500 to the live donors as compensation while Government of Kingdom of Saudi Arabia has passed a law to pay Saudi Riyal 50,000 to live donor.
According to him, the news appearing in the press regarding illegal practices by some doctors in the 'trade of kidney transplantation' are not true. 'It was not possible to remove kidneys without the consent of the donor as it needed to be protected by perfusion with a cool medicinal solution to preserve organs. Then, the organs cannot be stored for a long time and must have to be transplanted within minimum time.
The organs have to be harvested by a specialist under aseptic conditions and there should be sufficient length artery, vein and Ureter to be anastomosed'. In India, 80,000 people reached end-stage of renal disease annually. Only 2000 receive transplants, while the other 78,000 die, he added.